Barrett's esophagus is a controversial condition.

We wish to respond to the comments provided by José Miguel Esteban López-Jamar and Ravishankar Asokkumar (1) about our report in this Journal (2). Some of the comments were perhaps prompted by inadequately explained or understood concepts, since they mention aspects that we never even considered or stated.

Correction to: Microleakage in class V composite and compomer restorations following exposure to a colutory prescribed for the treatment of xerostomy.

In the original publication of the article, one of the author names was published incorrectly as José L. Calvo. The correct name is José L. Calvo-Guirado.

TMD and GOHAI indices of Brazilian institutionalised and community-dwelling elderly.

RATIONALE AND OBJECTIVES: Considering the controversy in the literature regarding several aspects of temporomandibular dysfunction (TMD) in elderly populations and the absence of reliable data on elderly Brazilians in this field, this study consisted of an evaluation of TMD prevalence and the self-perception of oral health among institutionalised and community-dwelling elderly in São José dos Campos, Brazil. METHODS: Two hundred and fifteen community-dwelling and 185 institutionalised elderly people were evaluated by the Helkimo anamnestic (Ai) and clinical dysfunction (Di) indices and answered a questionnaire using the Geriatric Oral Health Assessment Index (GOHAI). RESULTS: The major prevalence of TMD symptoms was for the Ai0 (symptom-free) group (69.5%), while the major prevalence of clinical signs was for the DiI (mild) group (56%). Women presented a higher AiII classification than men (chi(2) test, p = 0.049). Community-dwelling elderly presented a significantly lower Ai0 classification than the institutionalised ones (Two ratios equality test, p < 0.001). There was no relationship between the institutionalised status and the clinical dysfunction index for Di0 and DiIII classification (Two ratios equality test, p = 0.194 and 0.535 respectively). The institutionalised elderly presented greater (One-way ANOVA = 0.005) self-perception of oral health (33.45) than did the community-dwelling group (32.66). There were only weak Pearson's correlations among the anamnestic (-33.0%) or clinical (-14.7%) findings by the TMD and GOHAI indices. Symptom-free (Ai0) institutionalised elderly presented better scores in all GOHAI dimensions and elderly representing an absence of clinical TMD signs (Di0) presented higher GOHAI physical dimension scores in both groups. CONCLUSIONS: The prevalence of TMD symptoms among this sample of elderly individuals was relatively low, self-perception of oral health was reasonable and a weak, inverse correlation was found between TMD signs and symptoms and elderly self-perception of oral health measured by the GOHAI index.

Psychophysiological Response and Fine Motor Skills in High-Altitude Parachute Jumps.

Clemente-Suárez, Vicente Javier, José Juan Robles-Pérez, Ketty Herrera-Mendoza, Beliña Herrera-Tapias, and Jesús Fernández-Lucas. Psychophysiological response and fine motor skills in high-altitude parachute jumps. High Alt Med Biol 18:392-399, 2017.-We analyzed the psychophysiological response and specific fine motor skill of an experienced jumper in HALO (high altitude low opening) and HAHO (high altitude high opening) parachute jumps. Eight HALO and eight HAHO jumpers were analyzed. They jumped at 5500 m, HALO jumpers opened the parachute at 500 m and HAHO jumpers at 4300 m of altitude. Before and after the jumps, parameters of muscle strength, cortical arousal, blood creatine kinase (CK) and glucose, blood oxygen saturation, rate of perceived exertion (RPE), and specific fine motor skills of an experienced jumper were assessed; during the jump, heart rate (HR), HR variability, and speed were evaluated. HALO and HAHO jumps produced a significant increase in CK, lactate, and RPE, and a decrease in glucose. HAHO decreased cortical arousal, presented a higher sympathetic modulation, and a higher HR during the jump than HALO. HALO and HAHO produced an increase in the physiological, sympathetic modulation and muscle destruction, and a decrease in cortical arousal and a higher blood lactate concentration only in the HAHO jump. Also, somatic and cognitive anxiety correlated with higher strength manifestation and muscle destruction. This novel research could be used to improve actual training systems in both civil and military parachute jumpers.

Estudio transversal: Prevalencia de arritmias cardiacas supraventriculares y factores asociados en pacientes adultos atendidos en consulta cardiológica. Hospital José Carrasco Arteaga, Cuenca, 2018 / Cross sectional Study: Prevalence of supraventricular cardiac arrhythmias and associated factors in adult patients seen at the outpatient cardiology service. Hospital José Carrasco Arteaga, Cuenca, 2018.

INTRODUCCIÓN: Las arritmias cardiacas son enfermedades cardiovasculares, causadas por alteraciones en la conducción o formación de estímulos eléctricos. La detección oportuna de estas alteraciones es crucial, pues a largo plazo mejora la calidad de vida de las personas que padecen estas patologías. El objetivo del presente estudio fue determinar la prevalencia de arritmias cardiacas supraventriculares y sus factores asociados en paciente adultos atendidos en la consulta externa de la unidad de cardiología del Hospital José Carrasco Arteaga, Cuenca, 2018. MATERIALES Y MÉTODOS: Se realizó un estudio observacional, transversal, descriptivo y de correlación con una muestra de 608 pacientes mayores de 18 años atendidos en la Institución mencionada que se realizaron electrocardiograma durante el año 2018. Se estudiaron las variables: estado nutricional, hipertensión arterial, diabetes, tabaquismo, medicamentos utilizados; edad y sexo; presencia de arritmia supraventricular. Se utilizó la prueba Chi cuadrado para buscar asociación entre las variables cualitativas; considerando diferencias estadísticamente significativas una p < 0.05. RESULTADOS: De 608 pacientes, el 57.1% fueron mujeres; 61.84% fueron menores de 65 años. El 43.9% tuvo sobrepeso, el 27.6% presentó IMC normal. Las enfermedades crónicas como HTA y Diabetes tuvieron una frecuencia de 44.4% y 16% respectivamente. La prevalencia de las arritmias supraventriculares fue del 3.8%. La fibrilación auricular fue la arritmia supraventricular más frecuente con el 47.8%, seguida de la arritmia sinusal con el 26.08%. Hubo mayor prevalencia de arritmias supraventriculares en el sexo femenino que en el masculino (4.6% vs 2.7%), en los pacientes con sobrepeso u obesidad que en los que tenían IMC normal ( 4.4% vs 2.3%), en los pacientes hipertensos en relación a los que no padecían de hipertensión (5.2% vs 2.7%), en los pacientes usuarios de medicamentos antitiroideos en relación a los que los consumían (50% vs 3.6%); sin embargo no se encontró asociación estadísticamente significativa con ninguna de estas variables. CONCLUSIÓN: La prevalencia de las arritmias supraventriculares fue del 3.8%. La principal de arritmia cardiaca diagnosticada fue la fibrilación auricular seguida de la arritmia sinusal. No se encontró asociación estadísticamente significativa entre la frecuencia de las arritmias supraventriculares y las variables estudiadas.(AU)

BACKGROUND: Cardiac arrhythmias are cardiovascular diseases, caused by disturbances in the initiation or conduction of electrical stimuli. The timely detection of these alterations is crucial, since in the long term it improves the quality of life of people suffering from these pathologies. The aim of this study was to determine the prevalence of supraventricular cardiac arrhythmias and their associated factors in adult patients treated in the outpatient clinic of the cardiology unit of Hospital José Carrasco Arteaga, Cuenca, 2018. METHODS: An observational, cross-sectional, descriptive and correlation study was carried out with a sample of 608 patients older than 18 years, at the mentioned Institution, who underwent electrocardiography during 2018. We studied the variables: nutritional status, arterial hypertension, diabetes, smoking, used drugs; age and sex; presence of supraventricular arrhythmia. We used Chi Square test to search for an association between the qualitative variables; considering statistical significance a p <0.05. RESULTS: of 608 patients, 57.1% were women; 61.84% were under 65 years of age. 43.9% were overweight, 27.6% had normal body mass index (BMI). Chronic diseases such as hypertension and diabetes had a frequency of 44.4% and 16% respectively. The prevalence of supraventricular arrhythmias was 3.8%. Atrial fibrillation was the most frequent supraventricular arrhythmia with 47.8%, followed by sinus arrhythmia with 26.08%. There was a higher prevalence of supraventricular arrhythmias in females than males (4.6% vs 2.7%), in overweight or obese patients than in those with normal BMI (4.4% vs 2.3%), in hypertensive patients than in those who didn't suffer from hypertension ( 5.2% vs 2.7%), in patients who used antithyroid drugs than in those who didn't use them (50% vs 3.6%); however, no statistically significant association was found with any of these variables. CONCLUSION: The prevalence of supraventricular arrhythmias was 3.8%. The most common cardiac arrhythmia was atrial fibrillation followed by sinus arrhythmia. No statistically significant association was found between the frequency of supraventricular arrhythmias and the variables studied.(au)

O não de Raimundo Silva: a pesquisa narrativa como alternativa teóricometodológica para enfrentar o cerco imposto pelas políticas educativas do tempo presente / The no of Raimundo Silva: narrative research as a theoreticalmethodological alternative to confront the siege imposed by the educational policies of the present time / El no de Raimundo Silva: la investigación narrativa como una alternativa teórico-metodológica para hacer frente al cerco impuesto por las políticas educativas del tiempo presente

Neste artigo apresentamos a pesquisa narrativa como uma estratégia teóricometodológica que, ao mesmo tempo, valoriza o conhecimento dos professores de Educação Física, e os fortalecem na luta contra os desígnios das políticas educativas em formulação no país ao longo do último ano, em especial a MP 746/2016 - "Novo Ensino Médio". Como contraponto, defendemos metaforicamente a formulação de narrativas do não, inspiradas na atitude do revisor de livros Raimundo Silva, personagem do romance "História do Cerco de Lisboa", do escritor José Saramago, que, em seu trabalho, acrescenta um não ao convite feito pelos clérigos portugueses aos cruzados para que os auxiliassem a tomar a cidade do domínio dos "mouros". Para nós, na produção de narrativas alternativas a dominante, sustentadas nas experiências do professorado, residem possibilidades para abrir a história (GAGNEBIN, 2013), reinventado e complexificando conhecimentos, criando alternativas locais e marginais ao "cerco" imposto pelas recentes políticas educativas(AU)

In this article we present the narrative research as a theoretical-methodological strategy that values the knowledge of physical education teachers, and strengthens them in the fight against the design of educational policies formulated in the country during the last year, especially the MP 746/2016. As a counterpoint, we metaphorically defend the formulation of non-narratives, inspired by the attitude of book reviewer Raimundo Silva, a character of the novel "The History of the Siege of Lisbon", by writer José Saramago, who in his work adds a no to the invitation made by the Portuguese clerics to the crusaders to help them take the city from the dominion of the "moors". For us, in the production of alternative narratives, based on the experiences of teachers, there are possibilities to open the history (GAGNEBIN, 2013), reinvented and complexifying knowledge, creating local and marginal alternatives to the "siege" imposed by recent educational policies(AU)

Este artículo presenta la investigación narrativa como una estrategia teóricometodológica que valora el conocimiento de los profesores de educación física y que los fortalezca en la lucha contra los interés de las políticas educativas en formulación en el país en el último año, sobretodo la MP 746/2016. Como contrapunto, defendemos metafóricamente la formulación de narrativas del no, inspiradas en la actitud del revisor de libros Raimundo Silva, personaje de la novela "Historia del Cerco de Lisboa" del autor José Saramago, que, en su trabajo, decidió añadir un no como respuesta a la invitación del clero portugués para que los cruzados les auxiliasen a tomar la ciudad, bajo el dominio de los "moros". Para nosotros, en la producción de narrativas alternativas a la dominante, sustentadas en experiencias del profesorado, residen posibilidades de abrir la historia (GAGNEBIN, 2013), reinventando y complejificando conocimientos, creando alternativas locales y marginales al "cerco" impuesto por las políticas educativas recientes(AU)

General health of elderly institutionalised and community-dwelling Brazilians.

OBJECTIVE: To evaluate the heart rate, blood pressure, blood glucose and other important indicators of the general health of an elderly population of São José dos Campos, Brazil. MATERIALS AND METHODS: A cross-sectional study was conducted among 150 institutionalised and 150 community-dwelling individuals aged 60 years or more. The parameters evaluated were heart rate, blood pressure and blood glucose. The elderly also answered a questionnaire about osteoporosis, falls, physical exercising, participation in social events, type of foods ingested, Alzheimer and Parkinson's diseases and medication. RESULTS: The institutionalised elderly showed an average heart rate of 75.1, while that of the community-dwelling elderly was 76.7. The percentage of systolic hypertension in the institutionalised and community-dwelling groups was 36% and 30% respectively, while diastolic hypertension showed a percentage of 40% and 57%, and diabetes was 32% and 30%. Among the institutionalised and community-dwelling groups, 13.3% and 21.3% respectively, reported osteoporosis, 31.3% and 42.7% falls, 7.3% and 24% exercised regularly, 4% and 69.3% participated regularly in social events, 58.7% and 51.3% reported eating solid foods, and 13.3% and 2%, respectively, suffered from Alzheimer's disease. Parkinson's disease was reported by 2% in both groups. The institutionalised elderly reported taking an average of 3.2 medications, while among community-dwelling elderly this number was 1.8. CONCLUSION: The entire sample presented a high prevalence of hypertension, diabetes and osteoporosis. No significant differences were found in the systemic health of the elderly institutionalised and community-dwelling groups. However, the latter group reported more frequent falls, participation in social events and exercised regularly.

Canting of the occlusal plane: Perceptions of dental professionals and laypersons

Objectives: To determine if canting of the occlusal plane influences esthetic evaluation of the smile among orthodontists, dentists and laypersons. Study Design: A frontal photo of a smile with 0º occlusal plane canting in relation to the bipupillary plane was modified using Adobe Photoshop C3 (Adobe Systems Inc, San José, California) to generate two images with occlusal plane inclinations of 2º and 4º. The three images were evaluated esthetically by orthodontists (n=40) general dentists (n=40) and laypersons (n=40). Each image was awarded a score as follows: 1=esthetically acceptable;2=moderately acceptable; 3=esthetically unacceptable. Evaluators also placed the three images in order in preference. Data were analyzed using the Kruskal-Wallis (p<0.05) and the Mann-Whitney tests, applying the Bonferroni Correction (p<0.016).Results: No significant differences (p> 0.05) were found between the three groups for 0º and 2º cants (median for orthodontists=1; general dentists=1; laypersons=1). Orthodontists (median score=3) made evaluations of the image with 4º occlusal plane that were significantly different from general dentists (median=2) and laypersons(median=2). All three groups put the 0º image in first place in order of esthetic acceptability, the 2º image in second place and the 4º image in third place. Orthodontists placed the 0º image in first place with significantly greater frequency (p<0.016) than laypersons. Conclusions: Occlusal plane canting of 0º and 2º were evaluated as esthetically acceptable by the three groups. The 4º occlusal plane cant was evaluated more negatively by orthodontists than by general dentists and laypersons. All three groups placed the 0º image in first place of esthetic acceptability, 2º in second place and 4º in third. Orthodontists put the 0º image in first place with significantly greater frequency than laypersons (AU)

Prevalencia de patología cervical premaligna y maligna en pacientes con citología negativa / Prevalence of premalignant and malignant cervical pathology in patients with negative cytology

En el Departamento de Patología del Hospital Universitario San José de Popayán, se procesaron durante el año de 1992 un total de 15480 citologías de las cuales sólo el 0.95 por ciento fueron positivas (PAP III-IV-V). El 93 por ciento correspondió a PAP II de la "Antigua Clasificación" (gráfica 1). Con el fin de incrementar el porcentaje tan bajo de patología cervical premaligna y maligna con el uso rutinario de la citología, se determinó llevar a cabo un monitoreo cervical utilizando: test de Schiller, colposcopia y biopsia dirigida a las pacientes con citología negativa (PAP II) y que a la especuloscopia presentaran ectropión (erosión) cervical, parcial o total. El análisis histopatológico de 124 pacientes con estas características demostró que un 59.6 por ciento tenían patología cervical premaligna o maligna: Lesión Intraepitelial escamosa de bajo grado (L.SIL) 51.6 por ciento; lesión intraepitelial escamosa de alto grado (H.SIL) 6.47 por ciento y Carcinoma INVASOR 1.67 por ciento. Para el tratamiento de estos pacientes se tuvoen cuenta: su edad, paridad, deseos de reproducción, la histopatología y la posibilidad de seguimiento

Hipertensão arterial: aspectos farmacológicos e terapêuticos / Arterial Hypertension: pharmacological and therapeutics aspects

A hipertensão arterial sistêmica (HAS) é uma doença poli­gênica, multifatorial, caracterizada por aumento da resistência vascular, associada a alterações metabólicas e hormonais com repercussão em órgãos-alvo, sendo responsável por cerca de 40% de incapacitação e alta frequência de internações A prevalência da hipertensão arterial varia de 22% a 44% em diferentes países e regiões. Em estudo realizado em São José do Rio Preto (SP), na população adulta (maior e igual a 18 anos) a prevalência (populacional) de hipertensão arterial foi de 26% com a seguinte distribuição por faixas etárias: 18 a 39: 11%; 40-49: 24%; 50 a 59: 45%; 60 a 69: 66% e maior e igual a 70: 69%3. Sir George Pickering admitia a não existência de valores li­mítrofes entre a normotensão e hipertensão, mas, ao contrário, a relação entre pressão arterial e mortalidade é quantitativa, significando que quanto maior o nível pressórico, pior será o prognóstico, sendo qualquer valor divisório, arbitrário...

A tragédia da gota / The tragedy of gout

Aborda-se o estado clínico e psicossocial de personalidades ilustres que sofreram de gota, analisando as tentativas terapêuticas empíricas do passado. Reis, papas, líderes religiosos, artistas famosos, escritores e filósofos pagaram tributo a esta doença, na época relacionada ao desregramento na vida das pessoas ricas e ociosas. Hipóteses patogênicas múltiplas foram aventadas para explicar sua etiopatogenia. A análise geral da obra alcança até a fase atual de nossas modernas concepçöes científicas. Faz-se um histórico da importância da colquicina no tratamento da moléstia. Recorda-se que o 1§ trabalho escrito por um brasileiro, José Pinto de Azeredo, data de 1788. Ressalta-se, com destaque, a importância da publicaçäo de 1946, de Barbosa Corrêa (pai), que estabeleceu näo ser a gota rara no Brasil, destruindo assim velho e arraigado preconceito. Divide-se o trabalho em 4 capítulos: A velha doença dos poderosos; Oprobium medicorum; O Dedo de Hermes e, A tragopodagra, capítulo este dedicado ao poema de Luciano de Samosata (125 d.C.), onde pela primeira vez em português se estuda o interessante poema médico relacionado, de modo vivo e impressionante, aos sofrimentos produzidos pela deusa da gota

Enfermedad de chagas en una población endemica / Chaga's disease in an population endemic

En este trabajo informamos los resultados obtenidos en el estudio epidemiológico sobre la enfermedad de Chagas, que realizamos en una zona que se consideró altamente endémica para diha enfermedad. Tomamos como muestra una población preseleccionada por el proyecto Mivica (Mejoramiento Integral de l Vivienda Campesina) en el Municipio San Francisco de Tiznados específicamente en el caserío Sabanota, Edo. Guárico. Realizamos la evaluación integral de los alumnos de la localidad encuesta serológica de Hemaglutinación Indirecta en 52 pobladores y 103 escolares. La prueba serológica fue realizada simultaneamente, desconociendo los resultados uno de otro, por los laboratorios del Centro de Investigaciones "Dr. José F. Torrealba" en San Juan de Los Morros y el Laboratorio de la Escuela de la Dirección General Sectorial de Saneamiento Ambiental en Maracay, Edo. Aragua. Obtuvimos 100 por ciento de concordancia en los resultados. En los sujetos seropositivos se práctico ECG, de reposo y evaluación cardiológica, procedencia y tiempo de permanencia en dicha zona. Encontramos que a partir de los 30 años de edad los índices de positividad aumentan considerablemente. A mayor tiempo de residencia en dicha zona, mayor porcentaje de positividad. Detectamos además, cambios electrocardiográficos por otros autores como: Trastornos de conducción, Arritmia Ventricular e Hipertrófia de Ventrículo Izquierdo (HVI)

Características del cancer gástrico en el Hospital Regional Universitario José María Cabral y Báez / Features of gastric cancer at Jose Maria Cabral y Baez Regional

Antecedentes: El cáncer gástrico es una patología frecuente en nuestro pais y nos pareció interesante reportar las características de 16 casos que fueron debidamente estudiados para ver si se correspondía con lo reportado en otros paises. Materiales y Métodos: Se llevó a cabo un estudio retrospectivo sobre las características de 16 casos de cáncer gástrico en Hospital José María Cabral y Báez de la ciudad de Santiago, República Dominicana, que se diagnosticaron en el período septiembre 1990 a septiembre 1995. Resultados: El sexo masculino fue el mas afectado con 76// (12 casos) y el grupo etario 60 a 69 años en el que con mayor frecuencia se presentó con 31// de los casos (5); en el antro pilórico se presentaton 68// de los casos (11). Histológicamente 88// (14) de los casos fueron adenocarcinomas y 12// (2) leiomiosarcomas. Comentario: Las características del cáncer gástrico en el Hospital José María Cabral y Báez coinciden con lo reportado en otras regiones

Rabdomiolisis por picaduras múltiples de abeja: a porpósito de un caso / Rhadomyolysis by multiple bee stings incidentally of case

Se trata de pre-escolar masculino de 3 años de edad natural y procedente de San José de Los Altos que ingresa por picaduras múltiples de abeja. Signos vitales frecuencia cardiaca 124 pm frecuencia respiratoria 26 rpm presión arterial 100/60 mm de Hg. Malas condiciones generales. Consciente palidez cutáneo mucosa, con edema facial acentuado múltiples zonas eritomatosas y equimóticas de 100 a 120 ponzoñas distribuidas en cuero cabelludo, cara, cuello, tórax y miembros superiores. En las primeras 4 horas presenta hematuria cicroscópica. A las 72 horas elevación de la Presión arterial 12/98 mm de Hg con una TAM de 108 mm de Sg. Laboratorio: hemoglobina 8.3 g/dl. Leucocitos 28.000 mm3, Glicemia 202 mg/dl, Urea: 105 mg/dl, Creatinina 1.1 mg/dl. Creatinfosfocinasa total 21.800 UI/L. Plaquetas 90.000 mm3. Aspartato transferasas 138 UI/L Bilirrubina total 1.88 mg/dl. Bilirrubina Directa 1.36 mg/dl. Uroanálisis Hemoglobina 4+. Proteínas 2+. Hematies 10-15 por campos. Cilindros 3-4 por campos. Tratamiento: Hidrocortisona: Meleato de clorofeniremina. Cimetidina, Furosemida, Bicarbonato de sodio, Plasma fresco congelado, Oxacilina, Bromoro de Ipratropio-Bromidrato de fenoterol, Captopril ibuprofen, Albúmina Humana. Permanenciendo hospitalizado por 12 días egresando hemodinámicamente estable. Se ha observado un aumento de casos recibidos en la Emergencia Pediátrica en los últimos años, por lo que publicamos este caso grave de picaduras múltiples de abeja Apis mellipera.

Uso de drogas entre estudantes universitarios em Sao Jose do Rio Preto, Sao Paulo / Use of drugs among university students in Sao Jose do Rio Preto, Sao Paulo

Em levantamento realizado em uma amostra de 1268 estudantes universitarios de Sao Jose do Rio Preto em 1991, foram obtidos percentuais de usuarios de varias drogas psicoativas. Quando se considerou a categoria de usuarios na vida as drogas com maior percentual de utilizacao foram as inalantes. Contudo na categoria de usuarios frequentes, maconha aparece como a droga mais consumida. Com relacao ao uso das drogas injetaveis, 1,5 por cento dos universitarios pesquisados revelaram ser usuarios na vida, fato importante, pois a essa pratica estao associados serios agravos a vida. Os percentuais de usuarios de drogas entre os estudantes universitarios foram sempre maiores para o sexo masculino em relacao ao sexo feminino em todas as categorias e tipos de drogas analisados. Variaveis como moradia e ocupacao mostraram-se relacionadas ao assunto em estudo.